The Truth about Germs in Health Clubs

Super bugs: the hype, the truth and what you can do to keep your members healthy.

Mutant pathogens. Germs. Super bugs. Thriving bacteria. The list of names for the microorganisms that can be found anytime, anywhere — including your club — is anything but comforting. Recent media articles and news magazine programs have brought front-and-center attention to certain microbes, especially antibiotic-resistant ones and their presence in fitness facilities.

Because the common perception is that gyms are dirty, dank and dark, health clubs are a seemingly perfect place for microorganisms to thrive. With many people coming in and out, touching multiple surfaces and sweating in close proximity to one another, the club environment seems like it would be a bug's ideal breeding ground.

Many in the fitness industry remember an undercover investigation that aired on ABC News: Primetime in early 2005. After swabbing a number of items in a typical health club, testers found staphylococcus, streptoccus viridans, diptheroids, E.coli and candida, which causes yeast infections. A similar story was aired on the Today show, just a few weeks ago. Research from the University of Arizona found that some cold and flu viruses can survive on surfaces for up to 72 hours, whether it's in the home, club or office. Recently, the biggest super bug of all — methicillin-resistant Stephylococcus aureus (MRSA) — has started popping up outside of hospitals. MRSA cases have been reported in contact sports facilities, military establishments and prisons, leaving many to believe health clubs are next.

The story doesn't end there.

Believe it or not, nothing inherent in sweat breeds disease, colds or the flu. Sweat is often just the mechanism for bacteria to move from hand to dumbbell or other pieces of fitness equipment. However not a single outbreak of MRSA — which is a type of staph bacteria resistant to a certain type of antibiotics, including the commonly prescribed penicillin, oxacillin and amoxicillin — has been contracted from a health club setting to date, says Jennifer Morcone, spokesperson for the Centers for Disease Control and Prevention (CDC).

“You could culture your computer or your desk and come up with a number of germs,” she says. “Bacteria and viruses live with us, and they're not always harmful and make us sick.”

Sure, colds go around, but good common sense can keep your members and staff protected, even from MRSA, which is generally contracted through skin-to-skin contact rather than contact with surfaces (for more information, see Q&A on p. 42).

“It's something the public should be aware of, and there are things that people can do to protect themselves — good hand hygiene, being mindful about not sharing equipment, etc.,” Morcone says. “If someone develops a rash or a boil and it's not resolving, they should ask their doctor to have it cultured and tested. It's treatable, but not with an antibiotic that a doctor would normally treat with.”

Clean Sweep

Besides keeping your members and staff healthy, a clean facility can keep a club's pocketbook healthy, too. Right up there with location, membership fees and hours of operation, a clean environment is crucial to attracting and retaining members.

At Main Event Fitness in Marietta, GA, providing a clean club to its members is a priority. During the day, a staff member cleans where it seems necessary, and at night, a detail crew cleans and disinfects all equipment, says Robert Scully, co-owner of the facility. A year ago, he even invested in an air sanitizer that performs ultraviolet germicidal irradiation. Is he concerned with MRSA? Absolutely.

“Fitness and wellness facilities like ours will need to stay in close touch with developments while using their best efforts to reduce risks at every location,” he says. “We think that we are doing as well as can be done at this point.”

Few of Main Event Fitness' members and potential members ask about the club's clean-air commitment and other cleaning protocols, but when you walk into the facility, the attention to detail shows, Scully says.

In fact, the perception of cleanliness may be paramount to getting and keeping members. For Skip Lennon, owner of 12 Gold's Gyms in North Carolina and South Carolina, cleaning is an ongoing and important issue. Lennon hired cleaning crews to come in during the day and at night, and he invests about $1,0000-$1,500 a month per facility (for a 16,000-square-foot club) on cleanliness, including sprays and center-pull towels for members to spray down their equipment after use. The money is well worth it, even if members don't cite cleanliness as a reason to renew.

“If someone comes in and they hear our club is dirty or nasty — that's horrifying,” he says. “We want to make sure it's clean, and hopefully they'll stay.”

Unfortunately, health clubs don't always have the cleanest of reputations. “We're a Gold's Gym and get the average person who has never been in but knows the brand and thinks of weights and sweaty guys,” Lennon says. “But if they see someone cleaning and see instant hand sanitizer on the wall, then they realize this isn't a dungeon.”

Ensuring that perception of cleanliness is even more challenging in an older club, which may not be dirty per se, but worn. When a brand-new facility opens down the street, an older club can take a hit because it doesn't have as fresh of an appearance. This is especially true when it comes to attracting certain demographics such as women and seniors, says Lennon, who owns both brand-new clubs and older clubs.

“We have a club in a retirement area with an older population, and this is huge for them,” he says. “Women take time to comment on how clean the club is.”

When cleaning, think about all areas of your facility — child care (where children don't always practice good hygiene), your group exercise room and the entryway. Although few members spend much time in your front entrance, it is your club's first, and sometimes lasting, impression.

To improve that impression even further, many facilities have started offering instant hand sanitizers (IHS) to both its staff and members. Although general hand washing (using warm water and soap and scrubbing for 20 seconds are key) is enough to protect from germs, IHS is perfect when soap and water are not available and hands aren't soiled. Main Event Fitness offers IHS to its staff, and Lennon has received compliments from his Gold's Gym members since offering IHS three years ago.

When it comes to cleaning equipment, nothing fancy is needed. Soap and water or bleach and a little manpower does just fine, Morcone says.

“You don't need the antibacterial stuff. Just clean thoroughly and vigorously to clean those pathogens away,” she says.

Perhaps the most important issue to address is teaching your members what their true risks are. Ironically enough, the worst thing is for people to not join a gym because they're afraid of getting sick.

“Physical activity and eating right makes your immune system stronger and helps fight infections better,” Morcone says. “Going to the gym is something we want people to do.”

Question and Answer about Staphylococcus Aureus and MRSA

What is Staphylococcus aureus (staph)?

Staph are bacteria commonly carried on the skin or in the nose of healthy people. About 25 percent to 30 percent of the population has staph bacteria in their noses without it causing an infection. Sometimes though, staph can cause an infection and it is one of the most common causes of skin infections. Most infections are minor (such as pimples and boils) and can be treated without antibiotics. However, staph bacteria also can cause serious infections, such as surgical wound infections, bloodstream infections and pneumonia.

What is MRSA (methicillin-resistant Staphylococcus aureus)?

MRSA is a type of staph that is resistant to beta-lactams antibiotics, such as methicillin, oxacillin, penicillin and amoxicillin. While 25 percent to 30 percent of the population is colonized with staph, about 1 percent is colonized with MRSA.

Who gets staph or MRSA infections?

The majority of MRSA infections occur in health care settings; however, it is becoming more common in the community setting. Data from a 2003 prospective study suggests that 12 percent of clinical MRSA infections are community-associated, but this varies by geographic region and population. Factors that have been associated with the spread of MRSA skin infections include close skin-to-skin contact, openings in the skin such as cuts or abrasions, contaminated items and surfaces, crowded living conditions and poor hygiene.

Can your members or staff get a MRSA infection at your club?

In MRSA outbreaks, the environment has not played a significant role in the transmission of MRSA. MRSA is transmitted most frequently by direct skin-to-skin contact. Members and staff can protect themselves by practicing good hygiene (e.g., washing hands with soap and water or using an alcohol-based hand rub and showering after working out), covering open skin areas such as abrasions or cuts with a clean dry bandage, avoiding sharing personal items such as towels or razors, using a barrier (e.g., clothing or a towel) between skin and shared equipment, and wiping surfaces of equipment before and after use. To date, there has not been a single outbreak of MRSA in a health club, but be sure to inform your members of your cleanliness policies or cleaning routine and answer any of their questions.

If someone believes they have a staph or a MRSA infection, what should they do?

Cover the wound with clean, dry bandages (bandages or tape can be discarded with the regular trash), and have them see their health care provider. Most staph and MRSA infections are treatable with antibiotics.

Tips for Keeping Your Members Healthy

Revisit your facility's existing cleaning and maintenance plan with all key staff and contractors, and determine if any changes need to be made.

Train your staff and make sure they are implementing the current plan(s).

Inspect and clean equipment and locker rooms immediately before and after your prime-time traffic periods.

Encourage your staff to wash their hands regularly with hot water and soap. Provide protective gloves for staff and employees, especially cleaning staff.

Revisit your local health codes and the regulations.

Keep spray bottles filled with a disinfecting solution, and make towels and/or disposable disinfecting wipes available to members to wipe down surfaces and equipment. (Note: A mix of 3 tablespoons of bleach to one quart of water in a spray bottle can be used to disinfect hard, non-porous surfaces.)

Post signage and remind members to clean equipment after use.

Assign staff to periodically inspect/clean equipment and surfaces in locker rooms throughout the day.

If you provide towel and/or laundry service:

Use bleach when cleaning club towels.

Use the hottest water possible and hottest heat setting on dryers for all laundry.

Avoid overfilling washers — overloaded washers are less effective.

Avoid allowing used towels to pile up for extended periods of time; research has shown that some types of bacteria can survive and thrive in the laundry.

Educate your members:

Remind members that regular exercise improves one's immune system.

Encourage members to report cleanliness concerns to senior staff and have a system in place for responding promptly.

Encourage members to wash hands regularly with hot water and soap.

Interview a local physician and collect information from online resources such as www.cdc.gov, then share common tips for protecting oneself in your member newsletter or a special mailing.

Source: Club Cleanliness: Tips & Tactics To Help Your Members Remain Healthy, International Health, Racquet and Sportsclub Association